ACA Navigator/Assister training requirements:

Transcription

1 ACA Navigator/Assister training requirements: A set of training standards, to be met by all entities and individuals carrying out Navigator functions under the terms of a Navigator grant, to ensure expertise in: (i) The needs of underserved and vulnerable populations (ii) Eligibility and enrollment rules and procedures (iii) The range of QHP options and insurance affordability programs; and (iv) The privacy and security standards applicable under Other Navigator requirements that relate to training needs: Provide information in a manner that is culturally and linguistically appropriate Accessibility and usability for individuals with disabilities

2 Navigator/Assister Training Exchange-wide Training Approach Core training modules are being developed that apply to all groups (staff, call center, navigator/assisters, agency partners) Each program supplements core training as needed to address program-specific business processes Core training modules being drafted by subject matter experts (Navigator team, Operations, HCA/Medicaid, OIC, etc.) Navigator/Assister Progress to date Established a work group consisting of a broad group of stakeholders and partners Identified guidelines for Navigator core knowledge, skills, competencies Identified training modules o Estimate approximately total training hours (core and Navigator-unique) o Prioritization and sequencing o Training format(s) Timeline Lead Organization responsibilities (as outlined in RFP) Screen In-Person Assister candidates (using core competency guidelines) Receive training from Exchange Train In-Person Assisters in their service area Notify the Exchange when a candidate has completed training and is ready to be scheduled for certification exam Certification Exam for Navigators/Assisters Exchange administers exam electronically Upon successful completion, issue certificate, notification, and sets up system access in the Healthplanfinder Next Steps: Start building introductory (non-system) courses Countdown to Coverage Review core curriculum for Navigator/IPA input Set up learning management system to track In-Person Assister training and certification Content review for Exchange core training

3 Assister Training Timeline March April May June July August September October Select Lead Orgs Develop Healthplanfinder RFP out March 8 Lead Organizations Chosen Develop training content Content manuals due from content experts June 1 Train HBE training staff (Chris Brown) Train Lead Organization Countdown to Coverage Testing on-going through August Contracts with Navigator organizations in place Develop manuals (self-help, practice tests, reading levels, etc), PowerPoints, recorded webinars and practice modules with Finder July 7th - August 2nd August Input Final Content on plans Lead organizations train and Certify Navigators. Train & Certify Assisters

4 COUNTDOWN TO COVERAGE RECORDED WEBINARS Topic Lead Review Date Delivery Date Scenarios from WG member 1. ACA 101 Big picture Chris April 5 April 26 APTC/CSR Medicaid Expansion 2. Exchange Shaina April 5 May 10 Security and Privacy PHI HIPAA Compliance 3. Insurance 101 Scott/Kris April 12 May 24 MAGI 4. Medicaid 101 Chris April 12 June 7 CHIP/Apple Health

5 Classic Medicaid 5. SHOP Scott/Kris April 5 June 21 Employee Employer 6. Customer Service TBD April 26 July 12 Call Center In-Person Assisters/Navigators Agents/Brokers Repeat series or add topics as Q and A highlights them Go into greater detail as we get closer to 10/1.

6 Core Training Topics TOPIC ORDER of MODULES ACA 101 Big picture includes Medicaid expansion Glossary of Terms Exchange Overview Program Access (Language, disability, etc.) (Either as part of Exchange Overview or as separate module tbd) Security and Privacy includes: PHI Authorized Representatives Appeals Validating Identity Medicaid 101 Medicaid Expansion MAGI 101 Referral process Conversion process

7 Classic Medicaid Qualified Health Plans Health insurance basics QHP basics (plan components, plan options, plan selection tools) Subsidies (Tax credits, cost reductions) Costs Consumer Assistance (Roles, functions, responsibilities, requirements, referrals) SHOP/Agent/Broker Navigators/in person assisters Call Center Healthplanfinder System Admin/account creation No need to specify Application-Eligibility (System and business rules) Enrollment (System and business rules, including premium payments) Correspondence

8 HBE RFP Appendix F In-Person Assister Knowledge, Skills, and Competencies Guidelines * Competency = the ongoing ability to maintain, update and demonstrate sufficient knowledge, skills, judgment, and qualifications necessary to practice safely and ethically in a designated role and setting in accordance with In-Person Assister requirements. One achieves continuing competency through active practice, self-assessment and reflection, and continuing education. Knowledge Skills Competencies* Qualities Relationships Create a safe place for people to discuss health issues Understand and Articulate client needs including people with low socioeconomic status, Limited English Proficiency, disabilities Ability to communicate effectively with lay people, people with disabilities, Limited English Proficiency, low-socioeconomic, chronic conditions Fluency in population served Effective Customer service skills Listening Skills Problem solving Conflict Resolution maintain control under difficult situations Ability to speak in language that lay people, people with disabilities, Limited English Proficiency, lowsocioeconomic, chronic conditions status can understand Relationship with community being served. Understanding of the special enrollment conditions for American Indians and Alaskan Natives Desire to help community Commitment to assure access to hard to serve and hard to reach individuals and groups

9 Content: Public and private health insurance ACA and the Health Benefit Exchange (HBE) Qualified Health Plans (QHP) Premium subsidies and how they are calculated Penalties for opting out of insurance coverage Bronze, Silver, Gold and Platinum tiers Health Plan Quality metrics IRS information related to the HBE Privacy/Security Authorized representatives under state and federal law How the Healthplanfinder works Referral Role of In-Person Assister, Agent- Broker, Call Center Pass off points between groups. The correct parties to direct people to, in what circumstances. Limit to In-Person Assister s role Use Health information technology Explain insurance information Refer people to Agent- Broker Refer people to services for additional health resources and information Computer skills Data collection skills (use HBE metrics) Ability to speak in language that lay people, people with disabilities, Limited English Proficiency, lowsocioeconomic, chronic conditions status can understand Ability to communicate effectively with that lay people, people with disabilities, Limited English Proficiency, lowsocioeconomic, chronic conditions Communication Skills Computer Skills Resources available to improve skills/competencies: (Disclaimer: HBE does not require these courses and there is no implied HBE endorsement or guarantee regarding the quality and content.)

10 Computer skills: Microsoft Digital Literacy: First Course This e-learning course can be played online or downloaded to be played on a local machine. It begins with friendly videos that explore how computers are an essential part of school, work, and modern life. The course then provides hands-on lessons about using the mouse and keyboarding. Offered in multiple languages. Training options for individuals to expand their competency skill set: Department of Health: Whatcom Community College. CWoods@whatcom.ctc.edu Whatcom Community College (WCC). WCC has developed an 11 hour Introduction to Community Health Worker course. Clark College. Developing an AA degree program for Community Health Workers. Mark Gaither is heading the effort. MGaither@clark.edu The Washington State Community Action Partnership has a certified training program covering core competencies.